Omental bleeding with spontaneously derotated torsion

Nihei, Zenro; Kojima, Kazuyuki; Uehara, Koichiro; Sawai, Shigeo; Kakihana, Masahiko; Hirayama, Renzo; Mishima, Yoshio

doi:10.1007/bf02471059

Cited by 27 publications

(21 citation statements)

References 6 publications

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“…The precipitating factors include local trauma, occupational vibrationassociated omental damage, and conditions that induce omental displacement, such as hyperperistalsis following a heavy meal, as occurred in our patient, or increased intra-abdominal pressure resulting from heavy exercise, coughing, or excessive straining. 3,4 When torsion occurs, venous return is compromised, the distal portion of the omentum becomes congested and edematous with hemorrhagic extravasation of characteristic serosanguinous fluid into the peritoneal cavity, and aseptic peritonitis. As the torsion proceeds, arterial occlusion leads to hemorrhagic infarction and fat necrosis, followed by an inflammatory reaction.…”

Section: Discussionmentioning

confidence: 99%

Primary Torsion of the Greater Omentum: Report of a Case

et al. 2002

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Primary or idiopathic torsion of the greater omentum is an uncommon cause of acute abdominal pain, often mimicking other acute abdominal conditions. The diagnosis is usually made at laparotomy, with the presence of free serosanguinous fluid in the absence of any other intra-abdominal pathology being suggestive of this condition. Resection of the infarcted segment is the treatment of choice, offering rapid recovery and reducing the possibility of adhesion formation. We report a case of primary omental torsion and discuss the diagnostic and therapeutic implications of this entity.

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Section: Discussionmentioning

confidence: 99%

Primary Torsion of the Greater Omentum: Report of a Case

et al. 2002

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“…3 In our hospital we have encountered this unusual condition in 5 of 868 laparoscopies performed for appendicitis (1 : 173) during the last 6 years. 5 An accurate preoperative diagnosis is rarely made, since most patients undergo emergency surgery for acute appendicitis (66%) or cholecystitis (22%). 1 Leitner 7 proposed that infarction of the greater omentum may be primary (idiopathic) or secondary, and that it may occur with or without torsion (Table 1).…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5] The symptoms of progressive peritonitis usually dictate immediate surgical treatment and therefore, a diagnosis is rarely made before laparotomy. 1 We report herein a pathological findings; however, in the upper right quadrant we detected large amounts of serohemorrhagic ascites and a 2 ϫ 4 ϫ 5-cm solid, hemorrhagic, and necrotic section of the greater omentum firmly wedged between the liver and right hemidiaphragm (Fig.…”

Section: Introductionmentioning

confidence: 99%

Idiopathic segmental infarction of the greater omentum successfully treated by laparoscopy: Report of case

et al. 2000

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Idiopathic or spontaneous segmental infarction of the greater omentum (ISIGO) is a rare cause of acute right-sided abdominal pain. The symptoms simulate acute appendicitis in 66% of cases and cholecystitis in 22%. Progressive peritonitis usually dictates laparotomy, and an accurate diagnosis is rarely made before surgery. The etiology of the hemorrhagic necrosis is unknown, but predisposing factors such as anatomic variations in the blood supply to the right free omental end, obesity, trauma, overeating, coughing, and a sudden change in position may play a role in the pathogenesis. We present herein the case of a 37-year-old man in whom ISIGO, precipitated by obesity and overeating, was successfully diagnosed and treated by laparoscopy. Resection of the necrotic part of the greater omentum is the therapy of choice, and ensures fast recovery and pain control. Serohemorrhagic ascites is a common finding in ISIGO, and careful exploration of the whole abdominal cavity should be performed. The laparoscopic approach allows both exploration and surgical intervention.

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“…Bizde hastanın kliniğinin akut apandisit açısından kuşkulu ve ultrasonoğrafinin normal olması nedeni ile başka patoloji çıkabileceği düşünülerek paramedian bir kesi ile laparatomi yapıldı ve omentum torsiyonu tanısı konuldu. Litera-türde omentum torsiyonunun konservatif olarak tedavi edilebileceği yönünde görüşler olsa da yaygın görüş torsiyone segmentin rezeksiyonudur (7,9). Sonuç olarak, omentum torsiyonu preoperatif tanı konulması zor bir akut karın sebebidir.…”

Section: Discussionunclassified

Primary Omentum Torsion

Okos¹,

Duran²,

Çapraz³

2012

JAEMCR

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Omentum torsion is a rare cause of acute abdomen. Omentum torsion generally takes place on the right side and clinically mimics appendicitis, so for this reason omentum torsion is generally diagnosed by laparatomy carried out for appendicitis. For differential diagnosis from appendicitis it is important that pain starts suddenly after a heavy meal or hard exercise in omentum torsion and also pain is not accompanied with nausea, vomiting and anorexia. A 54 year-old female patient with suspected appendicitis was operated on and a right paramedian incision was employed. Primary omentum torsion was diagnosed and the infarcted tissue resected. We suggest that in cases where acute appendicitis is uncertain omentum torsion and other pathologies must be considered. In these cases a paramedian incision and diagnostic laparascopy may provide benefit for diagnosis. Keywords: Omentum torsion, acute appendicitisReceived: 12.01.2011Accepted: 09.02.2011 ÖZETOmentum torsiyonu oldukça nadir görülen bir akut karın nedenidir. Omentum torsiyonu sıklıkla sağda olması ve kliniğinin akut apandisite benzer olması nedeni ile sıklıkla akut apandisit nedeni ile yapılan laparatomide tanı almaktadır. Ancak ağrının sıklıkla aşırı yemek, ani hareket veya ağır egzersizi takiben birden başlaması ve bulantı, kusma, iştahsızlığın genelde eşlik etmemesi apandisitten ayırıcı tanıda önem arz eder. Bizde akut apandisit kliniği şüpheli olan 54 yaşında bayan olgu sağ paramedian kesi ile opere edildi ve primer omentum torsiyonu tanısı konarak torsiyone segment rezeke edildi. Akut apandisit kliniği şüpheli olan olgularda omentum torsiyonu ve benzeri patolojiler olabileceği düşünülerek paramedian kesi, diagnostik laparoskopi gibi alternatiflerin göz önünde bulundurulmasının faydalı olacağını düşün-mekteyiz. Anahtar Kelimeler: Omentum torsiyonu, akut apandisitBaşvuru Tarihi: 12.01.2011

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Omental bleeding with spontaneously derotated torsion

Cited by 27 publications

References 6 publications

Primary Torsion of the Greater Omentum: Report of a Case

Primary Torsion of the Greater Omentum: Report of a Case

Idiopathic segmental infarction of the greater omentum successfully treated by laparoscopy: Report of case

Primary Omentum Torsion

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